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Hoping for Success this time

My DS is will be FIVE days old today. His brother is three years older than he is. And when he was born, I failed horribly at nursing for different and various reasons. Regardless, I am now determined to EBF our newest after my second c-section. Nurses said he was doing well in the hospital. He prefers to eat off one breast at a time, from anywhere to 10-30 (and there are times when he's been at the breast for even 45) minutes, every 2-4 hours!

Yesterday, my milk officially began to come in and I am engorged! He sleeps A LOT and it is difficult to wake him, I have tried numerous methods. His latch is good, etc. and he is pooping / wetting diapers up to standard. My issue is that my breasts hurt. I've been hand expressing small amounts of milk (1/2 ounce over the course of today), as to allow him to continue latching well - although, I have noticed he doesn't seem to have a problem (so far) one way or the other. Also, I am leaky!

A while ago he ate from one breast, took the other one and suddenly pulled away after five minutes with at least 1/2 ounce of milk dribbling onto me. He never drank, but my breasts felt better. Is this sort of thing normal, or ok?

What can I do to relieve these breasts.. without screwing up our supply, etc.

Will this pain go away?

Do I/should I pump? (I bought a small manual, just in case but am so hesitant to use it).

Sorry for the long, drawn out post at 4 am our time in AZ... but any advice would be so helpful right now.

Re: Hoping for Success this time

When you say your breasts hurt, what do you mean? Is the pain due to feeling overfull or engorged, or are you having nipple pain, or are you having a burning or itching pain?

I am honking that the most probable cause of your discomfort is engorgement, and if that is the case it is going to be a temporary problem. Most moms overproduce when they first start making mature milk- it's nature's way of ensuring that small, weak, sleepy, uncoordinated newborns have plenty of milk available to them while they learn to nurse. But your body doesn't want to overproduce for long- it's a waste of energy, it can make nursing more difficult for the baby, and it puts you at increased risk for plugged ducts and mastitis. So eventually your body will "read" that extra milk is sitting in the breast, not being removed by the baby, and it will reduce supply to a more reasonable level. This last bit is why you want to avoid the pump: every time you remove milk from the breast in addition to what the baby is taking, your body reads that as a sign that the milk is needed, and it makes the same amount all over again.

If you need to express a small amount of milk in order to allow the baby to latch, that's fine. An additional 1/2 oz of milk isn't a big deal. But in general, the more you put up with the engorgement, the faster your supply will ratchet back to a more reasonable level.

Things to do to treat engorgement:
- go braless as much as possible (pressure from a bra is a good way to end up with a plugged duct, and tight bras can reduce supply too much- and whatever bras you ought, they probably don't fit all that well right now!)
- use cold cabbage leaves or cold compresses on your breasts
- feed the baby frequently- small, frequent feedings are ideal for preventing you from getting overfull and uncomfortable

I think you should offer both breasts at a feeding while your baby is very small. Not only should that result in baby getting plenty of milk, but it will also remove a small amount of milk from each breast at every feeding- and that might make you less uncomfortable. Finally, nursing on one breast per feeding is a very minor form of block feeding, and it can result in inadequate supply.

Do you have a lactation consultant, preferably an IBCLC, available to you?

Re: Hoping for Success this time

When you say your breasts hurt, what do you mean? Is the pain due to feeling overfull or engorged, or are you having nipple pain, or are you having a burning or itching pain?

They are definitely overfull and engorged. I could not even lay down comfortably last night due to them being so large. I guess in this respect, I am lucky?

Originally Posted by @llli*mommal

I am honking that the most probable cause of your discomfort is engorgement, and if that is the case it is going to be a temporary problem.

This is a relief to hear, you have no idea. Is there any standard "time frame" in which they will reduce the supply to something more reasonable, or is it just a "wait and see" type of thing from here?

Originally Posted by @llli*mommal

This last bit is why you want to avoid the pump: every time you remove milk from the breast in addition to what the baby is taking, your body reads that as a sign that the milk is needed, and it makes the same amount all over again.

Good! So glad I left it in the box last night then!

Originally Posted by @llli*mommal

Things to do to treat engorgement:
- go braless as much as possible (pressure from a bra is a good way to end up with a plugged duct, and tight bras can reduce supply too much- and whatever bras you ought, they probably don't fit all that well right now!)
- use cold cabbage leaves or cold compresses on your breasts
- feed the baby frequently- small, frequent feedings are ideal for preventing you from getting overfull and uncomfortable

How do I go about with the cabbage compresses exactly? I do have a fresh head of cabbage, just uncertain as to use it properly.
And when you say, small and frequent, how frequent and how long should I be doing this for?

Originally Posted by @llli*mommal

Do you have a lactation consultant, preferably an IBCLC, available to you?

There are IBCLCs in my area I found online last night. I will call the closest one to set up an appointment. Do you know how much they generally cost to see? Am I over worrying about this entirely?

Thank you again for all your help. Like I said, I really truly want to be successful this time and am willing to do whatever it takes. If it means asking a thousand and one seemingly silly questions!

SUPER PROUD mommy of Brandon, age 3 (2/3/10) and Anthony, age 5 days (2/8/13)

Re: Hoping for Success this time

They are definitely overfull and engorged. I could not even lay down comfortably last night due to them being so large. I guess in this respect, I am lucky?

Well, being engorged does mean you're probably making more than enough milk, and that's good. But engorgement is no fun! Are you having any issues with swelling or fluid retention in addition to that in your breasts? Sometimes moms who have c-sections or moms who had a lot of IV fluids end up with swelling issues, and that can complicate/exacerbate engorgement issues.

This is a relief to hear, you have no idea. Is there any standard "time frame" in which they will reduce the supply to something more reasonable, or is it just a "wait and see" type of thing from here?

Most women see the worst of the engorgement pass within a few days. If it continues to be problematic longer than that, see the lactation consultant.

How do I go about with the cabbage compresses exactly? I do have a fresh head of cabbage, just uncertain as to use it properly.

Have someone wash a few cabbage leaves for you and stick them in the fridge. When they're cold, stick them in your bra or tank too (you'll need to wear one for this trick). Just be cautious- some women have a rapid and rather extreme response to cabbage leaves and can end up with lowered supply.

And when you say, small and frequent, how frequent and how long should I be doing this for?

Since your baby is still so brand new, you want to make sure he eats around 10-12 times in a 24 hour period. If he wants to nurse more than that, great. Don't worry about nursing for X number of minutes- artificial time limits aren't breastfeeding-friendly. It's best to take the approach of allowing the baby finish the first breast at his own pace, and then offering the second breast when he comes off the first. So whether he feeds on the first breast for 5 minutes or 30 minutes, it's all good.

[QUOTE]
There are IBCLCs in my area I found online last night. I will call the closest one to set up an appointment. Do you know how much they generally cost to see? Am I over worrying about this entirely?[/QUOTE=]

IBCLCs charge very different rates depending on who you talk to. I was lucky- my IBCLC regards her work as her "ministry" and didn't charge me a dime! But some moms end up paying fees in the $100 range. Either way, it is worth it, especially when you compare it to the money you'd spend on formula.

Like I said, I really truly want to be successful this time and am willing to do whatever it takes. If it means asking a thousand and one seemingly silly questions!

There are no silly questions! And if you want to be successful and have the determination to do whatever you need to do, you WILL be successful!

Re: Hoping for Success this time

All the info from the PP is great. I would also suggest that while you do want to avoid any constricting bras or tops, you might try wearing a stretchy sleep bra (something along these lines -- http://www.toysrus.com/product/index...pbnCh29fgAAEAA). For me personally, when I was engorged at the beginning, my breasts were SO tender and sensitive that going braless was impossible ... I needed a little support to keep things from jostling too much. You can also tuck nursing pads in them to absorb leakage (which is totally normal by the way). Warm (but not too hot) showers can also help ease discomfort - instead of directly facing the water, you can put your back to the shower head and letting the water very gently run over your shoulders and front. As far as the time frame, the initial super tender phase (where they really feel like they "hurt") should pass within a few days, maybe a week or so at most. You might still have heightened sensitivity for a few more weeks after that, but the breast tissue shouldn't hurt anymore once supply syncs up with baby a little better. Engorgement is definitely uncomfortable but it will pass!